Health and Disease, Rx to Wellness, Uncategorized

Diabetes Drugs and Flesh Eating Infection

Newer Diabetes Drugs Linked to ‘Flesh-Eating’ Genital Infection

News Picture: Newer Diabetes Drugs Linked to 'Flesh-Eating' Genital Infection

 

Say you have type 2 diabetes and you are taking a newer class of medications to treat your disease — but one day you notice pain, redness and a foul odor in your genital area.

If this happens, new research suggests you need to see your doctor immediately, because you may be suffering from Fournier gangrene. Also known as a “flesh-eating” disease, this infection attacks your genital or anal region and can quickly kill tissue as it spreads rapidly.

Unfortunately, it has become a rare but still possible safety concern for people taking diabetes medications known as SGLT2 inhibitors, according to U.S. Food and Drug Administration scientists.

SGLT2 inhibitors are a newer class of diabetes medications, introduced in 2013. Drugs in this class include canagliflozin (Invokana), dapagliflozin (Farxiga) and empagliflozin (Jardiance).

Fournier gangrene occurred in 55 people taking these drugs between March 2013 and January 2019. For comparison, the researchers looked for cases of Fournier gangrene in people taking other diabetes medications from 1984 to 2019. They found only 19 such cases.

Still, the risk for Fournier gangrene remains very low, the researchers stressed.

“In 2017, an estimated 1.7 million patients received a dispensed prescription for an SGLT2 inhibitor,” said study author Dr. Susan Bersoff-Matcha, a medical officer in the FDA’s Center for Drug Evaluation and Research. So, “Fournier gangrene is a rare event,” she said. “While our study shows an association between treatment with SGLT2 inhibitors and Fournier gangrene, we don’t know exactly what the risk is, or if Fournier gangrene can be predicted.”

Broad-spectrum antibiotics and surgery to remove the dead tissue are treatment options, the researchers said.

SGLT2 inhibitors work in the kidneys, allowing excess blood sugar to be removed in the urine, they said.

In addition to lowering blood sugar levels, the drugs may also reduce the risk of heart disease and stroke in some people with type 2 diabetes.

But possible side effects include urinary tract infections and genital infections, such as yeast infections. Kidney problems can also be a concern with this class of medications.

All of the patients with Fournier gangrene identified in this study needed to be hospitalized. Some had several surgeries. Three of the 55 people died from Fournier gangrene.

The average age of the people with Fournier gangrene was 56. Thirty-nine were men. Forty-one cases occurred in the United States. Thirty-one of the 55 cases identified were also taking an additional diabetes medication.

Of those with Fournier gangrene, 21 were using canagliflozin, 16 were using dapagliflozin and 18 were taking empagliflozin, the study said.

Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center in New York City, said that while the study was well-done, it cannot prove a cause-and-effect link between the drugs and the disease.

“Infections of the pubic and rectal area are quite common in people with diabetes, they don’t have Fournier’s. Fournier’s is a very aggressive, but extremely rare, disease,” said Zonszein, who wasn’t involved with the study.

When Fournier gangrene does occur, it’s hard to know if it is caused by a medication. He pointed out that a number of clinical trials have been done on SGLT2 inhibitors that have included tens of thousands of people, and there haven’t been any reports of Fournier gangrene.

“I counsel my patients about infections in the genitalia. The main concern is to be aware that they can occur. And, providers need to be more aware of Fournier’s. They have to immediately try to establish the cause of infection and aggressively treat it if they suspect Fournier gangrene,” Zonszein said.

He said a far bigger concern is uncontrolled diabetes and the risk of complications when blood sugar levels aren’t controlled. “The benefits of these medications outweigh the risks,” he said.

In a statement, Boehringer Ingelheim, the company that makes Jardiance (empagliflozin), said the company actively monitors for side effects related to their medications.

“We remain confident in the positive benefit-risk profile of empagliflozin, and empagliflozin-containing products, as outlined in the prescribing information,” the statement from Boehringer Ingelheim said.

The prescribing information of all SGLT2’s was recently changed to reflect the possible risk of Fournier gangrene, as directed by the FDA.

Janssen Pharmaceuticals, maker of Invokana (canagliflozin), and AstraZeneca, maker of Farxiga (dapagliflozin), did not respond to requests for comment.

 

 

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Annals of Internal Medician

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Uncategorized

Do You Have a Magnesium Deficiency?

magnesiumflower

Magnesium is arguably the most important mineral in the body. According to a pioneering American neurosurgeon, “Every known illness is associated with a magnesium deficiency and it’s the missing cure to many diseases.”

 

Magnesium is critical for cellular health and for more than 300 biochemical functions in the body. But get this: A common blood test often misses low levels. Here we discuss the main signs that you’re magnesium deficient — and how to reverse it.

Causes of Magnesium Deficiency

Once thought to be relatively rare, magnesium deficiency is more common than most physicians believe. Here’s why:

 

Soil depletion, genetically modified organisms (GMOs) and the chemicals in our food have created a recipe for disaster. As minerals are removed, stripped away, or no longer available in the soil, the percentage of magnesium present in food has decreased.

Digestive diseases, like leaky gut, can cause malabsorption of minerals, including magnesium. Today, there are hundreds of millions of people who aren’t absorbing their nutrients. Also, as we age, our mineral absorption tends to decrease, so the probability of having a deficiency increases across the board.

Chronic disease and medication use is at an all-time high. Most chronic illness is associated with magnesium deficiency and lack of mineral absorption. Medications damage the gut which is responsible for absorbing magnesium from our food.

Should you worry about magnesium deficiency?

Should you worry about magnesium deficiency?

It all depends on your risk factors and presenting symptoms.  Also, approximately 80 percent of people have low levels of magnesium, so the chances are that you are probably deficient.

Magnesium is arguably the most important mineral in the body.

According to Norman Shealy, MD, PhD, an American neurosurgeon and a pioneer in pain medicine, “Every known illness is associated with a magnesium deficiency and it’s the missing cure to many diseases.” Not only does Magnesium help regulate calcium, potassium and sodium, but magnesium is essential for cellular health and is a critical component of over 300 biochemical functions in the body.

Even glutathione, your body’s most powerful antioxidant that has even been called “the master antioxidant,” requires magnesium for its synthesis. Unfortunately, most people are not aware of this, and millions suffer daily from magnesium deficiency without even knowing it.

 

Causes of Magnesium Deficiency

Once thought to be relatively rare, magnesium deficiency is more common than most physicians believe. Here’s why:

 

Soil depletion, genetically modified organisms (GMOs) and the chemicals in our food have created a recipe for disaster. As minerals are removed, stripped away, or no longer available in the soil, the percentage of magnesium present in food has decreased.

Digestive diseases, like leaky gut, can cause malabsorption of minerals, including magnesium. Today, there are hundreds of millions of people who aren’t absorbing their nutrients. Also, as we age, our mineral absorption tends to decrease, so the probability of having a deficiency increases across the board.

Chronic disease and medication use is at an all-time high. Most chronic illness is associated with magnesium deficiency and lack of mineral absorption. Medications damage the gut which is responsible for absorbing magnesium from our food.

Should you worry about magnesium deficiency?

 

It all depends on your risk factors and presenting symptoms (see below). Also, approximately 80 percent of people have low levels of magnesium, so the chances are that you are probably deficient.

 

Take note: Only 1 percent of magnesium in your body is in your bloodstream, so often you can have a deficiency, and it would not even be discovered by a common blood test.

 

Magnesium Deficiency Symptoms

 

Many people may be magnesium deficient and not even know it. But here are some key symptoms to look out for that could indicate if you are deficient:

  1. Leg Cramps

Seventy percent of adults and 7 percent of children experience leg cramps on a regular basis. But leg cramps can more than a nuisance — they can also be downright excruciating! Because of magnesium’s role in neuromuscular signals and muscle contraction, researchers have observed that magnesium deficiency is often to blame. (1, 2)

More and more health care professionals are prescribing magnesium supplements to help their patients. Restless leg syndrome is another warning sign of a magnesium deficiency. To overcome both leg cramps and restless leg syndrome, you will want to increase your intake of both magnesium and potassium.

 

  1. Insomnia

Magnesium deficiency is often a precursor to sleep disorders such as anxiety, hyperactivity and restlessness. It’s been suggested that this is because magnesium is vital for GABA function, an inhibitory neurotransmitter known to “calm” the brain and promote relaxation.

Taking magnesium before bed or with dinner is the best time of day to take the supplement. Also, adding in magnesium-rich foods during dinner — like nutrition-packed spinach — may help.

 

  1. Muscle Pain / Fibromyalgia

A study published in Magnesium Research examined the role magnesium plays in fibromyalgia symptoms, and it uncovered that increasing magnesium consumption reduced pain and tenderness and also improved immune blood markers. (3)

Oftentimes linked to autoimmune disorders, this research should encourage fibromyalgia patients because it highlights the systemic effects that magnesium supplements have on the body.

  1. Anxiety

As magnesium deficiency can affect the central nervous system, more specifically the GABA cycle in the body, its side effects can include irritability and nervousness. As the deficiency worsens, it causes high levels of anxiety and, in severe cases, depression and hallucinations.

Magnesium is needed for every cell function from the gut to the brain, so it’s no wonder that it affects so many systems.

  1. High Blood Pressure

Magnesium works partnered with calcium to support proper blood pressure and protect the heart.  So when you are magnesium deficient, often you are also low in calcium and tend towards hypertension or high blood pressure.

A study with 241,378 participants published in the American Journal of Clinical Nutrition uncovered that a diet high in magnesium foods could reduce the risk of a stroke by 8 percent. (4) This is profound considering that hypertension causes 50 percent of ischemic strokes in the world.

  1. Type II Diabetes

One of the four main causes of magnesium deficiency is type II diabetes, but it’s also a common symptom. U.K. researchers, for example, uncovered that of the 1,452 adults they examined low, magnesium levels were 10 times more common with new diabetics and 8.6 times more common with known diabetics. (5)

 

As expected from this data, diets rich in magnesium has been shown to significantly lower the risk of type 2 diabetes because of magnesium’s role in sugar metabolism. Another study discovered that the simple addition of magnesium supplementation lowered the risk of diabetes by 15 percent! (6)

  1. Fatigue

Low energy, weakness and fatigue are common symptoms of magnesium deficiency. Most chronic fatigue syndrome patients are also magnesium deficient. The University of Maryland Medical Center reports that magnesium every day can help, but you do also want to be careful, as too much magnesium can also cause diarrhea. (7)

  1. Migraine Headaches

Magnesium deficiency has been linked to migraine headaches due to its importance in balancing neurotransmitters in the body. Double-blind placebo-controlled studies have proven that magnesium daily reduced the frequency of migraine headaches by up to 42 percent. (8)

  1. Osteoporosis

The National Institute of Health reports that, “The average person’s body contains about 25 grams of magnesium, and about half of that is in the bones.” (9) This is important to realize, especially for the elderly, who are at risk of bone weakening.

Thankfully, there’s hope! A study published in Biology Trace Element Research uncovered that supplementing with magnesium slowed the development of osteoporosis “significantly” after just 30 days. (10)

 

Are You at Risk? 

 

So, who is most susceptible to a magnesium deficiency? According to the National Institute of Health (NIH), not every one is created equal in regards to metabolizing and assimilating magnesium. In fact, certain people are inherently at a greater risk of developing a magnesium deficiency.

 

Magnesium deficiency can be inherited genetically as an inability to absorb this important mineral. Also, a diet low in high magnesium foods, or even emotional or work stress can drain magnesium from the body. Whether inherited, through a deficient diet, or even stress, a magnesium deficiency can lead to side effects of migraines, diabetes, fatigue and more.

 

Which one, How much, And what do I take with it?

 

These are all questions we will be happy to help you with.  We are not all wired the same way, and the same dose not work the same on everyone.  You need personalized healthcare plan just for you.  Call us for help in this matter, and we will work with you to get this right.

 

Health and Wellness Associates

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312-972-WELL

 

Health and Disease, Lifestyle

Less Sleep, Faster Brain Aging

lesssleep

Less Sleep, Faster Brain Aging

This troubling finding comes from a Singapore-based study showing that losing sleep with advancing age elicits changes in a region of the brain that is a marker for faster cognitive decline. The 66 Chinese seniors who participated had MRIs to measure their brain volume in conjunction with an evaluation of their cognitive function every two years. They also reported how many hours they typically slept. The researchers, from Duke-NUS Graduate Medical School Singapore, reported that study participants who slept fewer hours showed evidence of brain ventricle enlargement and declines in cognitive performance. This study was the first to look at the effect of sleep on brain ventricle enlargement, a known sign of cognitive decline. The investigators cited research elsewhere as showing that seven hours of sleep is associated with the best cognitive test scores in more than 150,000 adults, but noted that it is not yet known whether seven hours is optimum for overall physiology and long term brain health.

My take? This study adds a serious risk to the list of dangers posed by sleep deprivation throughout life. We know that lack of sleep increases the risk of accidents caused by fatigue and that not getting enough sleep is a risk factor for weight gain, perhaps by disrupting production of the appetite regulating hormones ghrelin and leptin. Sleep deprivation can also disrupt the body’s regulation of blood sugar, which can increase the risk of type 2 diabetes. And laboratory studies suggest that not getting adequate rest may also elevate levels of stress hormones, boost blood pressure, and increase inflammation – all changes that may lead or contribute to health concerns later in life. If you’re not getting enough sleep, the sooner you establish new habits, the better for the long-term health of your mind and body. Here are my recommendations for getting optimal sleep.

Want To Age Gracefully? It’s not about the lines on the face – it’s about the wisdom behind them. Don’t lament the passing of the years, celebrate all you have achieved, learned and earned, for your benefit and the benefit of others. Sources: June C. Lo et al, “Sleep Duration and Age-Related Changes in Brain Structure and Cognitive Performance.” SLEEP, 2014; DOI: 10.5665/sleep.3832